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To the Editor Dr Judson and colleagues1 discussed balancing extrinsic and intrinsic motivation for physician behavior. Any plan to alter physician behavior via applied motivation should have, as an intrinsic component, assessments to determine the full effect of the applied motivation. For example, Judson and colleagues provided an example of how financial incentives related to patient care revenues enhanced the delivery of patient services in an academic medical department. This approach has been successful in increasing clinical revenues across many academic departments.2 However, one untoward effect has been that time spent by academic physicians on academic activities such as clinical research and teaching has decreased by 50%.3 The effect of this change on the academic mission has been largely ignored.2
Meador KJ. Consequences of Influencing Physician Behavior. JAMA. 2016;315(21):2350-2351. doi:10.1001/jama.2016.1223